Background
This study focuses on laparoscopic surgery experiences at Shahid Dharma Bhakta National Transplant Centre (SDNTC) which could enable the patients to gain knowledge regarding its benefits than conventional way of surgery. The present study finds out the frequency of various forms of nephrectomy based on laparoscopic surgery. Moreover, this study accomplishes lap donor nephrectomy of kidney transplantation which is of its first kind in this part of country.
Methods
We retrospectively reviewed the in-patient medical records at SDNTC from November 2017 to January 2019. Laparoscopic surgery was performed in 50 patients. The demographic data, indication for surgery, duration and peri-operative outcomes were analyzed.
Results
Out of 50 cases, 34 (68%) had undertaken lap simple nephrectomy, 6 (12%) were lap pyeloplasty, 6 (12%) nephro ureterectomy, 1 (2%) radical nephrectomy, 1 (2%) lap donor nephrectomy for kidney transplantation, 1 (2%) heminephrectomy and 1 (2%) nephrectomy of hydronephrotic non functioning left crossed ectopia. The lap donor nephrectomy of a case for kidney transplantation is the first laparoscopic donor nephrectomy of Nepal undertaken by Nepalese team at SDNTC. Amongst all nephrectomy, 27 (54%) patients were operated on right side while 23 (46%) patients on left side. The median age of the patients was 38.56 years comprising of 32 (64%) male and 18 (36%) female. Transperitoneal approach was used in all 50 (100%) cases. The respective median operative time and hospital stay was 122.3 minutes and 5 days. The mean estimated blood loss was 74.1 cc where two patients required blood transfusion intra-operatively. Post–operatively, 1 (2%) patient had hematoma which was managed conservatively. Two cases (4%) patients were converted to open surgery.
Conclusions
Laparoscopic surgery is feasible and safe procedure at our government setup hospital with least cumbersome procedure and minimum complication associated with it.